A policy that UnitedHealthcare was poised to roll out that would have allowed it to retroactively deny ED claims isn’t moving forward yet. But that doesn’t mean case managers shouldn’t prepare for the payer, or others, to implement such policies.
This week's note from the instructor looks at a recent clarification published by CMS on reimbursement for certain provider-based rural health clinics.
This week's note from the instructor looks at a recent clarification published by CMS on reimbursement for certain provider-based rural health clinics.
CMS announced another round of changes to its Bundled Payments for Care Improvement program recently and said that while participation thus far has been voluntary, it may become mandatory starting as early as 2024.
Modifier -XE (separate encounter) is used to indicate a separate surgical operative session on the same date of service or a distinct encounter after the patient has left the hospital or changed status/locations within the facility. Use this flowchart to support accurate use as a template for your organization.
